1. A Community Based Pediatric Palliative Care Program
Presented by:
Jeanne Chirico, MPA
Vice President ,
Lifetime Care Home Care and Hospice

2. 1
2004
3
2002
2001
2002
1,4
2003
2,5,7, 8,6,9, 11
2003 10
BCBSRA

3. Eligibility Criteria Today might be considered A Population ACO Or A Special Needs Plan
Birth to 21 years of age
Perinatal High Risk Pregnancies
Member of Excellus/Univera Insurance plan
Physician believes that the child is at significant risk to die before the age of 21.
This may include an acute exacerbation of a chronic illness placing the child at risk to die before reaching adulthood

4. Primary Goal
Provide Qualified Staff, Education, and Emotional Support to families allowing a realistic option to have their child die at home.

5. Death at Home by Age
C-Net Data

6. Secondary Benefits
Parents comfort and choice to have children remain at home at end of life results in cost of care savings for the payer and high parental satisfaction

7. Table 2
Cost and Location of Death at 5 Moments in the Last Year of Life
Median Total Costs
Children/Adolescents
Year
6 months
3 months
1 month
Last week
Hospital (n=84)
$197,069
$113,110
$67,561
$45,615
$29,169
Home (n=74)
$116,708
$57,295
$24,521
$6,173
$1,213
Mann-Whitney U (p)
2269 (.003)
2031 (<.001)
1648 (<.001)
1149 (<.001)
729 (<.001)
Infants
Hospital (n=51)
$111,876
$94,025
$78,442
Home (n= 14)
$94,009
$77,406
$23,375
$12,508
$2,288
302 (.38)
240 (.06)
137 (<.001)
86 (<.001)
65 (<.001)
Note: p values are based on two-tailed tests

8. Cost Savings
Fully-Loaded Cost per Child per Year for CompassionNet = $6995 Last Year of Life Cost Savings for Child-Adolescent who died at home (based on Median Total Costs ) = $80, 361 Annualized Cost of Care Savings across the population of children that died at home = $5,946,714